Reporting the findings of a cluster randomized trial carried out in rural Kenya, Beth Kangwana and colleagues find that provision of packs of the malaria therapy artemether-lumefantrine in shops at a subsidized price more than doubled the proportion of children with fever who received drugs promptly. Importantly, whilst enabling cheap and easy purchase of malaria treatment in shops enabled treatment of about 44% of children with fever, this is still much lower than the target of treating 80% of children with fever set by the Roll Back Malaria Partnership. So in addition to this type of pragmatic solution to the problem of access to drugs, additional strategies will be required to boost the numbers of children with fever who are treated with antimalarials.
Funding: This work was financially supported by the Department for International Development, UK (DFID), the United States Agency for International Development (USAID), the Wellcome Trust, UK, and the Kenya Medical Research Institute (KEMRI). AMN is supported by the Wellcome Trust as a Research Training Fellow (#081829), RWS is a Principal Wellcome Trust Fellow (#079081), SB is supported by a Research Career Development Fellowship from the Wellcome Trust (#0811673), and CAG is a member of the Consortium for Research on Equitable Health Systems, which is supported by the UK Department for International Development. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: RWS chairs the Novartis National Malaria Control Programme Managers "Best Practice Workshops" in Africa for which he receives an honorarium.
Citation: Kangwana BP, Kedenge SV, Noor AM, Alegana VA, Nyandigisi AJ, et al. (2011) The Impact of Retail-Sector Delivery of Artemether-Lumefantrine on Malaria Treatment of Children under Five in Kenya: A Cluster Randomized Controlled Trial. PLoS Med 8(5): e1000437. doi:10.1371/journal.pmed.1000437
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FROM THE PLoS MEDICINE MAGAZINE
Migration can fuel anti-malarial drug resistance
In the third article in a six-part PLoS Medicine series on Migration & Health, Cally Roper and Caroline Lynch from the London School of Hygiene & Tropical Medicine, United Kingdom, use a case study of migration and anti-malarial drug resistance in Uganda to discuss the specific health risks and policy needs associated with the transit phase of migration.
Funding: No specific funding was received for writing this article.
Competing Interests: The authors have declared that no competing interests exist.
Citation: Lynch C, Roper C (2011) The Transit Phase of Migration: Circulation of Malaria and Its Multidrug-Resistant Forms in Africa. PLoS Med 8(5): e1001040. doi:10.1371/journal.pmed.1001040
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